Individual provider Active NPI

Nicole McWilliam, M.S., OTR/L

  • Occupational Therapist
  • Naperville, IL
National Provider Identifier
1821496555
Registry record updated Dec 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056.008517 Issued in IL
Practice address
535 W Ogden Ave
Naperville, IL 60563-3286
Phone
(630) 305-9400
NPI assigned
Dec 11, 2014
Last updated
Dec 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 056.008517 IL Primary

Addresses

Primary practice location

535 W Ogden Ave
Naperville, IL 60563-3286

Mailing address

9700 Gross Point Rd
Skokie, IL 60076-1175
Phone (847) 674-7210

Other practice location 1

9700 Gross Point Rd
Skokie, IL 60076-1175
Phone (847) 674-7210

Other names 1

  • Nicole Guerra Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171017002167 IL Practitioner - Occupational Therapist in Private Practice 7416223508 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
056.008517ILMDOccupational Therapist

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1418256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1821496555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9700 GROSS POINT RD",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761175",
            "telephone_number": "847-674-7210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 W OGDEN AVE",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605633286",
            "telephone_number": "630-305-9400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9700 Gross Point Rd",
            "address_purpose": "LOCATION",
            "city": "Skokie",
            "state": "IL",
            "postal_code": "600761175",
            "country_code": "US",
            "telephone_number": "847-674-7210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCWILLIAM",
        "first_name": "NICOLE",
        "credential": "M.S., OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-11",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.008517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "GUERRA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.